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目的探讨18F-FDG PET/CT显像在诊断肺癌骨转移中的应用价值。方法对67例确诊的肺癌患者分别采用CT诊断、MRI诊断、99Tcm-MDP SPECT和18F-FDG PET/CT显像诊断检查是否发生骨转移,对各法诊断所得数据录入SPSS 17.0进行ROC曲线分析,以肺癌骨转移的诊断灵敏度、误诊率和漏诊率为衡量指标进行统计学分析。结果与CT、MRI和99Tcm-MDP SPECT误诊率比较,18F-FDG PET/CT误诊率显著降低(P<0.05);与CT和MRI漏诊率比较,18F-FDG PET/CT漏诊率显著降低(P<0.05)。表明,18F-FDG PET/CT显像对肺癌骨转移的诊断灵敏度与其他方法无显著性差异、误诊率显著降低、漏诊率明显低于CT和MRI。经过ROC分析,CT、MRI、99Tcm-MDP SPECT、18F-FDG PET/CTROC的曲线均位于机会线之上,18F-FDG PET/CTROC与其他方法曲线下面积相比,差异有统计学意义(P<0.05)。结论18F-FDG PET/CT是一种非侵入性、安全的显像方法,在肺癌及其骨转移灶的诊断和探测上具有较高的特异性和敏感性,值得临床推广应用。
Objective To investigate the value of 18F-FDG PET / CT in the diagnosis of bone metastasis of lung cancer. Methods Sixty-six patients diagnosed with lung cancer were examined by CT, MRI, 99Tcm-MDP SPECT and 18F-FDG PET / CT respectively. The data of each method were collected and analyzed by SPSS 17.0 for ROC curve analysis. The diagnostic sensitivity, misdiagnosis rate and misdiagnosis rate of bone metastasis of lung cancer as the measurement index were statistically analyzed. Results The misdiagnosis rate of 18F-FDG PET / CT was significantly lower than that of CT, MRI and 99Tcm-MDP SPECT (P <0.05). The misdiagnosis rate of 18F-FDG PET / CT was significantly lower than that of CT and MRI <0.05). The diagnostic sensitivity of 18F-FDG PET / CT imaging for bone metastases of lung cancer was no significant difference with other methods, the misdiagnosis rate was significantly decreased, the rate of misdiagnosis was significantly lower than that of CT and MRI. After ROC analysis, the curves of CT, MRI, 99Tcm-MDP SPECT, 18F-FDG PET / CTROC were all above the chance line, and there was significant difference between the 18F-FDG PET / CTROC and the area under the curve of other methods <0.05). Conclusion 18F-FDG PET / CT is a noninvasive and safe imaging method. It has high specificity and sensitivity in the diagnosis and detection of lung cancer and its bone metastases. It is worthy of clinical application.